Sex and Race Differences in Cardiac Sarcoidosis Presentation, Treatment and Outcomes.
BACKGROUND: Although sex- and race-based patterns have been described in the extracardiac organ involvement of sarcoidosis, cardiac sarcoidosis (CS)-specific studies are lacking.
METHODS: We studied CS presentation, treatment and outcomes based on sex and race in a tertiary-center cohort. Multivariable adjusted Cox proportional hazards and survival analyses were performed for primary composite outcomes (left ventricular assist device, heart transplantation, all-cause death) and for secondary outcomes (ventricular arrhythmia and all-cause death.
RESULTS: We identified 252 patients with CS (108 female, 109 Black). At presentation with CS, females vs males (P = 0.001) and Black vs White individuals (P = 0.001) more commonly had symptomatic heart failure (HF), with HF most common in Black females (ANOVA P < 0.001). Treatment differences included more corticosteroid use (90% vs 79%; P = 0.020), higher 1-year prednisone dosage (13 vs 10 mg; P = 0.003) and less frequent early steroid-sparing agent use in males (29% vs 40%; P = 0.05). Black participants more frequently received a steroid-sparing agent (75% vs 60%; P = 0.023). Composite outcome-free survival did not differ by sex or race. Male sex had an adjusted hazard ratio of 2.34 (95% CI 1.13, 4.80; P = 0.021) for ventricular arrhythmia.
CONCLUSION: CS course may differ by sex and race and may contribute to distinct clinical CS phenotypes.
Published In/Presented At
Duvall, C., Pavlovic, N., Rosen, N. S., Wand, A. L., Griffin, J. M., Okada, D. R., Tandri, H., Kasper, E. K., Sharp, M., Chen, E. S., Chrispin, J., & Gilotra, N. A. (2023). Sex and Race Differences in Cardiac Sarcoidosis Presentation, Treatment and Outcomes. Journal of cardiac failure, 29(8), 1135–1145. https://doi.org/10.1016/j.cardfail.2023.03.022
Medicine and Health Sciences
Department of Medicine, Cardiology Division